CMS Publishes Free Hospice-Specific Comparative Data Reports Nationwide.
For those that are not familiar, PEPPER is the Program for Evaluating Payment Patterns Electronic Report (PEPPER) and it includes hospice-specific data statistics for Medicare claims that may be at risk for improper payments. While PEPPER does not identify the presence of improper payments, it can be used as a guide for auditing and monitoring efforts. A hospice can use PEPPER to compare its claims data over time to identify areas of potential concern and to identify changes in billing practices.
The PEPPER report itself contains a single hospice’s claims data statistics (obtained from the UB-04 claims submitted to the Medicare Administrative Contractor (MAC) or Fiscal Intermediary (FI)) for areas that could be at risk. The two areas the report will focus on are live discharge rates and long length of stay. Each hospice receives a PEPPER, which contains statistics for these target areas, regardless of whether the hospice’s data are of concern. The report shows how a hospice’s data compares to jurisdiction, state and national statistics. Data in PEPPER are presented in tabular form, as well as in graphs that depict the hospice’s target area percentages over time. PEPPER is developed and distributed by TMF Health Quality Institute, which is under contract with the Centers for Medicare & Medicaid Services (CMS).
Hospices can sign up for free training on the PEPPER reports. The PEPPER training will include the history and background of PEPPER, a description of the areas at risk for improper Medicare payments, a demonstration of a Hospice PEPPER to review the reports included and a discussion on how the PEPPER can be used. Registration for this session is restricted to staff of hospices; a recording of the training session will be made available on PEPPERresources.org within two weeks of the live session.
Additional information can be located on the PEPPER website where links to the following are contained: